Should Dark Chocolate Be Eaten By Those With Graves’ Disease and Hashimoto’s?

Published July 31st 2017

The chocolate industry is massive globally, with countries such as Switzerland and the United States eating large amounts of the sweet stuff. The largest consumption is in the former, with the average Swiss enjoying about 9.1kg of this food annually. The rest of the world may not be as much into chocolate, but it is evident that many people like having a bite occasionally. And since many of my patients with Graves’ Disease and Hashimoto’s Thyroiditis ask if it’s okay for them to eat dark chocolate while trying to restore their health, I figured I’d put together an article that focuses on this.

Of course the quality of chocolate that you eat is important. Knowing that most of the chocolate being sold contains hormone-harboring milk, among other undesirable ingredients, the effects of chocolate on one’s health is definitely a concern for many people. Fortunately, you can find chocolate that does not contain these ingredients, but it is not always easy to identify it.

Dark Chocolate vs. Milk Chocolate

Later in this article I will discuss the health benefits of dark chocolate, but I think it’s a good idea to start with a comparison of dark chocolate vs. milk chocolate. For many people, identifying the best type of chocolate is not always easy. And for those who wonder what the difference is between the different types of dark chocolate, the major difference between dark chocolate and other varieties is in the percentage of cacao content.

Dark chocolate typically will have between 50 and 100% cacao. While milk should not be one of the ingredients, some brands in the market contain dairy, yet still label it as being “dark chocolate”. So before purchasing dark chocolate please make sure you read the ingredients carefully.

As for the difference between dark chocolate and milk chocolate, dark chocolate is produced using a higher amount of cocoa, and typically will use cocoa butter instead of milk. Milk chocolate is solid chocolate made with milk. As for what type of milk is used, usually it is either a form of milk powder or condensed milk.

I didn’t realize that the manufacturer isn’t the one who decides how much chocolate or milk fat is used, as apparently the FDA is the one that sets the standards. So for example, milk chocolate must be at least 10% chocolate liquor (which is comprised of about half cocoa butter and half cocoa solids) and consist of 12% milk solids, while dark chocolate must be at least 15% chocolate liquor and less than 12% milk solids.

More About Dark Chocolate…

With many different brands available, it may be a little bit difficult to tell the good quality brands from the undesirable. Because the ingredients will always be revealing, it is always a good idea to check the contents before buying. Most good quality dark chocolate brands will have cocoa content of more than 70%.

And ideally you want to purchase organic dark chocolate. In addition, the best dark chocolate does not have any milk in it. If you find milk as one of the ingredients, even in trace amounts, then you know you do not have the right chocolate. In addition to the dairy, the sugar content of milk chocolate is likely to be higher than dark chocolate.

In short, the best dark chocolate rarely exceeds three ingredients. Mostly, it contains only sugar, cocoa mass and cocoa butter. If you are looking for a good quality dark chocolate, the most important point is to make sure these ingredients have not been supplemented with cheaper alternatives. A true dark chocolate lover can tell something is amiss from the aroma, taste or texture alone.

Having Problems Giving Up Milk Chocolate?

As a child, if you offered me some dark chocolate I probably wouldn’t have eaten it. Growing up I always preferred milk chocolate. Of course one reason is because it was more readily available, as whereas these days it’s common for all types of stores to carry dark chocolate, in the past this wasn’t the case. But even if it was more readily available I would have rejected the dark chocolate in place of a Hershey’s milk chocolate bar or a Nestle Crunch bar.

These days I eat a small amount of organic dark chocolate on a daily basis. And while I’ll admit that making the transition wasn’t easy for me, I’m glad I made the switch, and now I truly enjoy eating dark chocolate.

Free Radicals and Dark Chocolate

The production of free radicals is a normal process, but excessive amounts of free radicals can have numerous negative effects on the human body. An accumulation of free radicals leads to something called oxidative stress, which in turn can lead to the development of chronic and degenerative conditions such as cancer, autoimmune disorders, aging, cataracts, rheumatoid arthritis, cardiovascular and neurodegenerative diseases (1). Neutralizing the damaging effects of these free radicals is one reason why many people should consider enjoying some dark chocolate every now and then. Its rich content of flavanols, elements that contain antioxidant properties, provides an excellent thwarting effect against free radicals.

I’m not suggesting that eating dark chocolate alone will completely counteract the negative effects of free radicals. You of course want to eat an overall healthy diet, and minimizing your exposure to environmental toxins will also greatly reduce the amount of free radicals. But dark chocolate can be one of the nutrients which can help to reduce oxidative stress.

Dark Chocolate Research

I realize that most people reading this information aren’t excited about research studies, but I think it’s important to show proof of the health benefits of dark chocolate. And there is a lot of research showing its benefits.

Blood Pressure and Cardiovascular Health. Numerous studies show a positive effect of dark chocolate on the heart. A group of scientists carried out an interesting study in 2015. They established that consuming cocoa flavanol improves metabolic profile, blood pressure control and cognitive function (2). In another study, the researchers investigated the effect of dark chocolate consumption in cardiovascular disease patients. This time they took subjects aged between 40 and 65 years and measured for their central hemodynamic, blood pressure, peripheral arterial tonometry and brachial flow-mediated dilatation parameters. Again, the research results were in favor of dark chocolate intake (3). Another study mentioned that the free radical scavenging and metal chelating properties of cocoa flavanols are what offer a protective effect to the cardiovascular system (4).

Immunity. One study I came across showed that cocoa can inhibit the function of Th2 cells (5). In past articles I’ve spoken about Th1 and Th2 dominance, and how Graves’ Disease is considered to be a Th2 dominant condition, which means that eating dark chocolate might actually benefit people with this condition. Another study confirmed that cocoa might down-regulate the Th2 immune response (6). A very interesting study mentioned that cocoa has an inhibitory effect on the flu virus by enhancing a vaccination-induced immune response (7). And so instead of getting a flu shot perhaps you should just eat more dark chocolate!

Cognition. If you are a chocoholic, you will be pleased to know that dark chocolate is beneficial for brain health. Research looking at the relationship between cocoa and cognition demonstrate a dose-dependent improvement in general cognition, attention, processing speed, and working memory (8). In addition, cocoa flavanols might also exert a protective role on cognitive performance and prevent cognitive decline (8). A systemic review looked at the effects of chocolate on cognitive function, and found that three studies showed clear evidence of cognitive enhancement upon the consumption of cocoa flavanols (9). And while two studies failed to demonstrate behavioral benefits, it did identify significant alterations in brain activation patterns (9).

Mood. Many will agree that eating dark chocolate helps to improve their mood. A systematic review looked at some studies investigating the effects of chocolate on mood, and five studies showed either an improvement in mood or a decrease of negative mood (10). The authors said that it was unclear whether the effects of chocolate on mood are due to the orosensory characteristic of chocolate, or if it was due to the pharmacological actions of the constituents in the chocolate.

What comes out from all these and other studies is that there are some wonderful health benefits of dark chocolate. Compared to many other foods, dark chocolate contains a larger proportion of epicatechin, catechin and other flavonoids.

Can Dark Chocolate Benefit Thyroid Health?

Dark chocolate doesn’t seem to have a direct effect on thyroid health. However, ironplays an important role in thyroid hormone production. And dark chocolate is a good source of iron. However, as I’ll discuss later in this article, dark chocolate also has high amounts of phytic acid, which can inhibit the absorption of iron, along with other nutrients. And so I definitely wouldn’t rely on dark chocolate as your main source of iron.

Flavonoids were the focus of a 2003 study titled “Flavonoids and thyroid disease” (11). The study showed that high amounts of flavonoids can actually inhibit thyroid hormone production. Remember that dark chocolate contains these antioxidants, although the percentage may vary depending on the brand. However, flavonoids are also found in many other foods, such as vegetables, fruits, and nuts. And while eating an excessive amount of flavonoids might be problematic, this probably isn’t an issue with most people, and there are many studies which show the health benefits of flavonoids.

How Much Dark Chocolate Should You Eat each Day?

You might be wondering how much dark chocolate per day should you consume? Most dark chocolate bars come with their serving sizes, and so you can bet you will get different recommendations. Different people consume dark chocolate at different frequencies, so it is difficult to come up with a recommendation that works for everyone.

However, as every nutritionist will tell you, the key word is “moderation”. I came across one article which mentioned that to fully benefit from dark chocolate one has to eat approximately 3.5 to 7 ounces per day. This would mean eating one or two bars per day! I definitely don’t agree with this, and I personally eat one or two small squares (or rectangles) per day.

Why Is Chocolate Not Allowed On An Autoimmune Paleo Diet?

With all of the health benefits of dark chocolate, it’s discouraging to find out that it’s excluded from an autoimmune Paleo diet. But why is this the case? The purpose of an autoimmune Paleo diet is to avoid foods which are common allergens and can have a negative effect on gut healing.

Although dark chocolate isn’t considered to be a common allergen, it supposedly has a high amount of phytic acid, which can prevent the absorption of certain nutrients. Cacao beans carry the highest amount of phytic acid, but even after refinement, some portion of this remains. Another thing to keep in mind is that cocoa is high in oxalates (12), although so are other AIP-friendly foods such as spinach and sweet potatoes. I spoke about the risks of oxalates in a separate article entitled “Oxalates, Kidney Stones, and Thyroid Health”.

With that being said, does the high amount of phytic acid make dark chocolate a bad option for everyone on an AIP diet? We could say it all depends on the individual. Although I do recommend for those following a strict AIP diet to avoid dark chocolate, I’ve also had some patients continue to consume small amounts and do fine.

The problem with consuming dark chocolate and any other excluded food is that it’s impossible to predict who will do fine when eating a certain “forbidden” food. So when someone with Graves’ Disease or Hashimoto’s is following an autoimmune Paleo diet and asks me if it’s okay for them to eat a small amount of dark chocolate, the honest answer is “I don’t know”. The good news is that even if you avoid dark chocolate initially while trying to restore your health, most people are eventually able to reintroduce it back into their diet.

In summary, many people love eating dark chocolate, and fortunately there are many positive health benefits associated with it. Although there are no studies showing a direct relationship between chocolate and thyroid health, I mentioned how dark chocolate can have a positive effect on immune system health, which might suggest that eating dark chocolate will benefit people with autoimmune thyroid conditions. However, due to the phytic acid, dark chocolate is excluded from an autoimmune Paleo diet. But while I do have my patients with Graves’ Disease and Hashimoto’s avoid dark chocolate initially, it’s something that most people can reintroduce without a problem.